The current status of pediatric airway management among anesthesiologists in indonesia

Maintaining an adequate airway is crucial for an anesthesiologist, particularly in pediatric patients. However, airway management in children requires specific training and familiarization with technique and equipment. As the biggest archipelago in the world, Indonesia has a big challenge to implement standard of services, hence the lack of pediatric anesthetists increase the risk of anesthesia management in children, particularly airway management. The aim of this survey was to assess the current practice of airway management among anesthesiologist in Indonesia. After obtaining approval from Research and Ethics Committee from our institution, internet base questionnaire was distributed in a group of alumni of anesthesia residency program Faculty of Medicine Universitas Indonesia. Study data were collected and managed using REDCap electronic data capture tools hosted at Faculty of Medicine Universitas Indonesia. Responses were noted and analyzed using Statistical Package for Social Sciences (SPSS) version 18. The response rate of the survey was 72% (126 participants). Distribution of responder covered 29 of 34 provinces in Indonesia with more responders are from the west part of Indonesia (figure 1). Most of the responders were General Anesthesiologist (75.4%), hence, only 5.6% were pediatric anesthesiologist, considering the lack of particular subspecialty in Indonesia. The numbers of pediatric anesthesia cases are low. Only 19.1% responders perform more than 20 cases of pediatric anesthesia per month. However, 6 from 7 of pediatric anesthesia carried out more than 20 cases per month. One hundred respondents (79.4%) report of using cuffed ETT for children <8 years old. Our survey showed that Supra glottis airway devices (SGAD’s) and Stylet were widely available (>90%) across the country. however, the availability of more advance airway equipment were below 45% (Figure 2). The University hospitals were likely more equipped than Government hospital. Pulse oximeters were routinely used to monitor oxygen saturation during airway management. However, Capnography for confirming the correct position of endotracheal tube were not routinely use, irrespective the availability. To Conclude, our survey showed that lack of pediatric anesthesiologist contribute to lower pediatric airway management cases, irrespective of airway devices availability.